Coaxial illuminated laser endoscopic probe and active numerical aperture control

ABSTRACT

A coaxial illuminated laser endoscopic probe and active numerical aperture control apparatus and method of use, succinctly known as an illumination and laser source, capable of selectively providing illumination light and laser treatment light through a single optical fiber. The apparatus and method is especially useful during ophthalmic surgery. The present art is capable of providing the aforesaid through an optical fiber of such small size that heretofore said fiber was only useable for laser treatment light only. The present art also, with its unique optical system, allows for two illumination light outputs from a single illumination source. The apparatus utilizes a phototoxicity risk card to calibrate the system to prior art or safe illumination levels since the unique optical system provides illumination light of greater intensity than the prior art.

This Application is a Divisional of prior U.S. patent application Ser.No. 10/900,939 entitled Coaxial Illuminated Laser Endoscopic Probe andActive Numerical Aperture Control filed on Jul. 27, 2004, now pending.

This application claims priority of U.S. Provisional Patent ApplicationsNo. 60/490,399 filed Jul. 28^(th), 2003, and No. 60/550,979 filed Mar.5, 2004, both entitled Coaxial Illuminated Laser Endoscopic Probe andActive Numerical Aperture Control and No. 60/577,740 entitled MedicalLight Intensity Phototoxicity Control Card filed Jun. 5^(th), 2004, andNo. 60/577,618 entitled Photon Illumination and Laser Ferrule filed Jun.5^(th), 2004.

BACKGROUND OF THE INVENTION

The art of the present invention relates to fiberoptic endoscopic probesfor vitreoretinal surgery in general and more particularly to anapparatus and method for delivery of both broad spectrum illuminationand coherent laser treatment pulses through a common optical fiber. Thepresent invention also provides surgical illumination intensity controlby providing an apparatus and method for quickly and easily providing afiber optic illumination light output intensity reference to ophthalmicsurgeons. The present invention also utilizes a unique fiber opticconnector ferrule which uniquely indicates to the aforesaid apparatussource whether the fiber is designed, best suited, or desired forillumination or laser transmission light or both. Also integral to thepresent invention is an optical power meter, preferably for measurementof laser output power emanating from the optical fiber.

Prior art vitreoretinal surgical procedure utilizes discrete andseparate optical fibers for the delivery of typically non-coherent lightfor illumination and coherent laser beam light for surgical treatment oftissues. Although prior art “illuminated laser probes” of variousconfigurations have been developed, they all utilize separate opticalfiber or fibers for the non-coherent illumination stream and thecoherent laser delivery. The aforesaid fibers are typically arrangedside by side inside of a common needle lumen. An embodiment of thisprior art technology is found in U.S. Pat. No. 5,323,766, issued toUram. This prior art technology requires a larger or more than oneincision in order to introduce illumination and laser treatment lightinto the eye or other structure, thereby generating greater trauma tothe surgical site.

Prior art devices typically utilize a laser deliver core optical fiberdiameter of typically 200 to 300 microns since said diameter providesthe surgical laser burn spot size most commonly desired by the surgeon.The aforesaid prior art devices have been unable to provide sufficientsurgically useful illumination (non-coherent white light) power throughsuch a small fiber, primarily due to the prior art's inability to focussaid non-coherent surgically useful light onto such a small spot size.Moreover, none of the prior art devices have combined the aforesaidsurgically useful illumination and laser treatment light and transmittedthrough a single fiber, especially of the aforesaid small size.

The present art apparatus and method provides coaxial delivery of bothbroad spectrum illumination and coherent laser treatment pulses througha common optical fiber. In a preferred embodiment, the apparatus firstcomprises a non-coherent light source (coherent in an alternativeembodiment) capable of coupling sufficient illumination light into anoptical fiber with a core diameter suitable for vitreoretinal lasertreatment light delivery. That is, to provide a volume of light to thesurgical site which is sufficient for illumination of the surgicalprocedure. In a preferred embodiment said core fiber diameter istypically 200 to 300 microns since said diameter provides the surgicallaser burn spot size most commonly desired by the surgeon. The aforesaidoptical fiber is typically a multi-mode stepped index fiber in apreferred embodiment. Alternative embodiments may vary the type and sizeof the optical fiber without departing from the scope of the presentart.

An object of the present invention is to utilize a light source capableof using 250 micron (or smaller) optical fibers while still providingsimilar surgically useful lumen output to current 750 micron fibersources (typically 10-12 lumens). The source output aperture of thepresent invention in a preferred embodiment is at least 0.5 na(numerical aperture). Alternative embodiments may vary this numericalaperture without departing from the scope of the present invention. Thecolor of the light delivered by the present invention appears whitedespite the light power output or intensity. Also, the output intensityis capable of reduction without significantly affecting the color,aperture, or homogeneity of the light. The output bandwidth of theaforesaid light is substantially limited to the visible spectrum, thatis both UV and IR light are minimized. An option for user selectablelimitations (separate from the UV and IR limitations) in the outputspectrum is provided. Apparatus conformance to relevant safety standardsis also provided.

Prior art illumination light sources typically require a minimumaggregate optical fiber core area equivalent to a fiber diameter ofapproximately 500 microns in order to deliver sufficient illuminatinglight to be considered useful by the surgeon. A fundamental prior artlimitation with utilization of smaller light fibers for illumination isthe size of the focus spot in the light source itself. In a preferredembodiment, the art of the present invention utilizes a small geometryarc lamp which is capable of focusing to an extremely small illuminationspot size due to its extremely small plasma ball. This focusingattribute allows for efficient coupling of illumination light into anoptical fiber of 100 to 300 micron core diameter which is typicallyutilized for laser treatment light delivery. Utilization of theaforesaid preferred embodiment allows for up to 40 milliwatts ofillumination light to be delivered by a fiber previously considered toosmall to be an efficient illumination light source.

The aforesaid present art light source includes an input aperture orconnector for the attachment of a laser coupling fiber. The aforesaidaperture attachment is somewhat similar to the method by which atreatment laser is attached with an ophthalmic slit lamp. That is, via afiber optic pigtail typically equipped with a mechanical outputconnector such as an exi sma. In the preferred embodiment, dichroicoptics and/or other optical path design techniques are used to coaxiallycouple a treatment laser beam into the illumination optical path, andinto an endoscopic probe optical fiber. That is, with the aforesaidcoupling arrangement (using a single fiber), the present art apparatusand method allows a unique single and smaller optical fiber to beutilized for both illumination and laser treatment purposes. The art ofthe present invention further provides a new generation ofvitreo-retinal endoscopic instrumentation which utilizes the prior artspace occupied by larger illumination fibers and is also capable ofproviding such in a smaller cross-sectional fiber bundle.

The present art accepts laser light from various surgical laser sources,mixes said laser light with illumination light, and launches both down asingle fiber. Laser output aperture is minimized and the laser light isnot substantially affected by the illumination dimming or other spectraloutput limiting. An aiming beam is visible within the illuminationoutput pattern. Unique to the present art is a shadow appearance in theoutput light cone which indicates the location of laser treatment uponactivation of a laser light source. Power losses through the system arealso minimized. As aforesaid, the laser mixing method does notsignificantly affect illumination when not in use (i.e. color, aperture,or homogeneity).

Another unique feature of the present art invention is the ability tochange the angular light output from an endoscopic probe coupled withthe aforesaid coaxial optical fiber by actively controlling the focuscharacteristics of the light source. That is, prior art light sourceshave a fixed numerical aperture focus configuration which is typicallydesigned to fill the full acceptance cone of the mating opticalillumination fiber. The present art invention further comprises andutilizes surgeon controlled condensing optics to provide a variablefocused light output from the endoscopic probe and efficient couplinginto different fiber types. This is especially useful for coupling withoptical fibers having different numerical aperture requirements.

Ophthalmic surgical illumination devices for use with optical fibers arefound in the prior art and have been manufactured by numerous companiesfor years. One of many such devices is described in U.S. Pat. No.4,757,426 issued to Scheller, et al. on Jul. 12, 1988, Entitled“Illumination System for Fiber Optic Lighting Instruments”. One of themost widely used illumination devices is the “Millennium” which ismanufactured by Bausch and Lomb®. Other manufacturers are Alcon® withthe “Accurus” and Grieshaber® with the “GLS150”. Due to the prevalenceof the aforesaid within the marketplace, it is desirable for new andhigh intensity illumination devices, such as the present art device, toprovide an intensity reference indication to ophthalmic surgeons whichallows them to reliably duplicate or mimic the illumination intensity ofone or more of the aforesaid prior art devices. This is especially truesince retinal photic injury is a possible complication of the need touse bright light to clearly visualize ocular structures during delicateophthalmic surgical procedures. The present art invention furtherrepresents a novel apparatus and method for providing the ophthalmicsurgeon with graphical photoxicity risk information in a clear and easyto understand manner. In a preferred embodiment, it is comprised of aninexpensive card that is removably attached to the control panel of asurgical light source in order to show the relationship between theoutput intensity of the light source and the likelihood of photicinjury.

Further included with the present art apparatus is an integral opticalpower meter which is in a preferred embodiment, capable of measuring thelaser power output emanating from the fiber optic. Alternativeembodiments of said laser power meter also measure the illuminationpower intensity.

Accordingly, it is an object of the present invention to provide acoaxial illuminated laser endoscopic probe and active numerical aperturecontrol apparatus and method of use which is capable of transmittingboth illumination (non-coherent) and laser (coherent) treatment lightthrough a single optical fiber of sufficiently small diameter that saidfiber may be used for laser treatment, especially in eye surgical orophthalmic applications.

Another object of the present invention is to provide a coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus and method of use which provides both a surgically usefulillumination (non-coherent) output and a combined laser (coherent)output.

Another object of the present invention is to provide a coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus and method of use with an illumination intensity control whichis usable by the surgeon to control illumination intensity withoutaffecting laser output power or laser beam spot size characteristics orillumination spectral content.

A further object of the present invention is to provide a coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus and method of use which connects with conventional laser lightsources.

A further object of the present invention is to provide a coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus and method of use which provides a shadow or aiming holewithin the illumination light cone projection where the laser treatmentis placed.

A still further object of the present invention is to provide a coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus and method of use which provides an intensity referenceindication to ophthalmic surgeons which allows them to reliablyduplicate or mimic the illumination intensity of one or more prior artdevices or allows them to understand and minimize phototoxicity risksrelating to the illumination output.

A still further object of the present invention is to provide a coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus and method of use which provides a unique ferrule or connectorfor optical fiber connection which uniquely indicates to the aforesaidapparatus source whether the optical fiber is designed, best suited, ordesired for illumination or laser transmission light or both.

A yet further object of the present invention is to provide a coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus and method of use which minimizes trauma to the patient andsurgical site.

A yet further object of the present invention is to provide a coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus and method of use which has an integral power meter formeasurement of laser output power.

SUMMARY OF THE INVENTION

To accomplish the foregoing and other objects of this invention there isprovided a device for providing non-coherent illumination light andcoherent laser treatment light through a single optical fiber of thesize typically used for laser treatment only. The apparatus isespecially suited for use during ophthalmic surgery.

The present art, in a preferred embodiment, utilizes a 75 watt xenon arclamp for its high luminance illumination (light density), greater than6000° K color temperature, and greater than 95 color rendering index.The xenon arc lamp further provides an extremely small point lightsource which allows for a smaller output illumination beam diameter.Unique to the present lamp source is a mount which allows forreplacement of the lamp and yet retains the location of the plasma ballof said source precisely at a predetermined location within the opticalcenter of the apparatus.

A classic spherical reflector and two lens light collection layout isutilized rather than other lower part count layouts, such as using anelliptical reflector or a combination of a parabolic reflector and lens.Light that is incident on the reflector is reflected back to the lamp. Afirst achromatic lens collimates light from the source and the upsidedown or inverted image. A second achromatic lens is located coaxial tothe first lens and focuses the light at its focal point. The opticalfiber is located at the focal point of the second lens. The aforesaidreflectors are preferably spherical rather than parabolic in order toreflect illumination light in the same form as sourced from the arclamp.

An additional separate illumination path is possible with the presentart. No other conventional illumination light source incorporatesmultiple light paths from a single lamp. The independent nature of thetwo paths allow different filtering and intensity control settings tothe two outputs.

Output dimming of the present art illumination is accomplished bysteering the first (collimating) or penultimate lens in a fashion thatdoes not change the lens numerical aperture or introduce shadowartifacts into the beam. A control knob allows the user to select thedesired illumination level by rotating the knob.

The output optical fiber connector is uniquely configured to provide theprecise positioning required while reducing cost. A precise connectorend is combined with an integral retention thread to reduce parts costand assembly time. An optional groove or recess is placed on a secondversion of the connector to provide for sensing the difference betweenillumination only and laser compatible output fibers. Placement of asmooth diameter connector into the output activates a switch which willallow the laser power to be mixed. Either the lack of a connector or thegroove under the switch will cause the switch to not activate and thelaser power will not be mixed in.

Regarding mixing of laser treatment energy or light, laser light isdelivered to the system via preferably 50 micron optical fiber orequivalent. Laser light exiting the delivery fiber is preferablycollimated using a 16 mm focal length achromatic lens or equivalent. Ifall safety requirements are met (i.e. laser output compatible fiberinserted and selection switch for laser output activated) a steeringmirror reflects the collimated laser light into the center of theillumination axis. This results in the output of the fiber having a coneof white light with a shadow in the center nearly filled with the laseraiming beam (treatment beam during treatment). That is, the laserprovides an aiming beam, typically red, when not fully activated fortreatment and a treatment beam, typically green, when fully activated.Without the shadow caused by the steering mirror the aiming beam wouldbe entirely washed out or imperceptible except at very low illuminationlevels.

As described, unique to the present art is a coaxial laser andillumination apparatus which heretofore has not be available orutilized. Also unique to the present art is a highly efficientillumination system which utilizes spherical reflectors and associatedlenses to capture a maximum light output and also provide a twin pathillumination light output from a single lamp source in order to feedfibers of diameter less than 500 microns which are conventionally usedfor laser treatment only. Further unique to the present art is a lasersteering mirror having a solenoid selectability which provides an aiminghole within the illumination path for laser placement. Still furtherunique to the present art is an illumination arc lamp system having anextremely small point light source which allows for an extremely smallillumination focus size or numerical aperture output. Also unique to thepresent art is an arc lamp mount which precisely places the plasma ballof the arc lamp at the focus center of the optics system. Also unique tothe present art is a unique dimming mechanism which moves the focalpoint of a dimming lens in order to provide dimming without introducingartifacts, chromatic aberrations, or changes of color temperature. Alsounique to the present art is a capability of connection with existingconventional laser light sources whereby laser treatment andillumination are both provided at an output of the present artapparatus.

The present art invention also represents a novel apparatus and methodfor providing the ophthalmic surgeon with graphical photoxicity riskinformation in a clear and easy to understand manner. In a preferredembodiment, an inexpensive card is removably attached to the controlpanel of the surgical light source. Preferably, the present art card isattached in close proximity to the light intensity control in order toshow the relationship between the output intensity of the light sourceand the likelihood of photic injury. The graphical representation on thecard acts as a guide for adjustment of the output intensity of thesource in relationship to an accepted standard, that is such as the“Millennium” from Bausch and Lomb®. In this way the spectral and powercharacteristics of the various elements involved in delivering light tothe eye are integrated into a single and easily manageable variable.This greatly reduces the complexity of judging the best intensity to usein a given situation.

The art of the present invention also comprises a ferrule or connectorhaving an internal bore, preferably stepped, which is substantiallyparallel with the lengthwise axis of the ferrule body. The aforesaidbore allows for placement and bonding or potting of an optical fiberwithin and through said ferrule body. Externally, said ferrule body isalso stepped in a unique form in order to optimally function asdescribed herein.

Where provided herein, dimensions, geometrical attributes, and threadsizes are for preferred embodiment informational and enablementpurposes. Alternative embodiments may utilize a plurality of variationsof the aforesaid without departing from the scope and spirit of thepresent invention. The art of the present invention may be manufacturedfrom a plurality of materials, including but not limited to metals,plastics, glass, ceramics, or composites.

BRIEF DESCRIPTION OF THE DRAWINGS

Numerous other objects, features, and advantages of the invention shouldnow become apparent upon a reading of the following detailed descriptiontaken in conjunction with the accompanying drawings, in which:

FIG. 1 is a top plan view of a preferred embodiment of the coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus showing illumination and laser light paths without thephototoxicity card, power meter, and ferrule connectors.

FIG. 2 is a perspective view of the arc lamp source and mount.

FIG. 3 is an assembly view of the arc lamp source and mount.

FIG. 4 is a front side plan view of the first lens mount, shaft mountedcam, and shutter with a closed position shutter shown in phantom.

FIG. 5 is a front side plan view of the steering mirror, post, bracket,ball slide, and solenoid in a non-energized extended position.

FIG. 6 front side plan view of the first output for laser andillumination light and the switch for sensing the recess in thealignment barrel.

FIG. 7 is a cross sectional view taken along line 7-7 of FIG. 6 withoutthe switch body attached.

FIG. 8 is a side plan view of the ferrule connector without the recessfor preferrably laser and illumination use.

FIG. 9 is a cross sectional view taken along line 9-9 of FIG. 8.

FIG. 10 is a side plan view of the ferrule connector with the recess forpreferably illumination use.

FIG. 11 is a cross sectional view taken along line 11-11 of FIG. 10.

FIG. 12 is a front side plan view of the front panel of the coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus housing showing the first output, illumination level controlknob, photoxicity risk card, and laser power meter display and sensor.

FIG. 13 is a right side plan view of the right panel of the coaxialilluminated laser endoscopic probe and active numerical aperture controlapparatus housing showing the second output, illumination level controlknob, laser connector, power and laser switches, and photoxicity riskcard.

FIG. 14 is an electronic schematic diagram of the laser power metercircuitry.

FIG. 15 is an optical schematic diagram of the preferred embodiment ofthe coaxial illuminated laser endoscopic probe and active numericalaperture control apparatus showing laser and illumination rays,reflectors, mirrors, and lenses.

FIG. 16 is an optical schematic diagram of an alternate embodiment ofthe coaxial illuminated laser endoscopic probe and active numericalaperture control apparatus showing laser and illumination rays,reflectors, mirrors, and lenses.

FIG. 17 is an optical schematic diagram of a further alternateembodiment of the coaxial illuminated laser endoscopic probe and activenumerical aperture control apparatus showing laser and illuminationrays, reflectors, mirrors, and lenses.

FIG. 18 is an optical schematic diagram of another alternate embodimentof the coaxial illuminated laser endoscopic probe and active numericalaperture control apparatus showing laser and illumination rays,reflectors, mirrors, and lenses.

FIG. 19 shows a left side plan view of the first lens mount.

FIG. 20 shows a front side plan view of the first lens mount at a fullintensity position

FIG. 21 shows a front side plan view of the first lens mount at a dimmedintensity position.

FIG. 22 shows a top plan view of an implementation of the alternateembodiments of the coaxial illuminated laser endoscopic probe and activenumerical aperture control apparatus as shown in the optical schematicsof FIGS. 16 & 17 showing illumination and laser light paths without thephototoxicity card, power meter, and ferrule connectors.

FIG. 23 shows a side plan half cross sectional view of the preferredembodiment of the first and second lenses which correct for color,spherical aberration, and coma and have a back focus 20 mm from the apexof the last element and a numerical aperture of 0.5.

FIG. 24 shows an optical schematic of the first lens set, collimatedspace, dichroic hot mirror filter, and second lens set with illuminationlight path rays shown.

FIG. 25 shows a detailed side plan half cross sectional view withdimensional attributes of the preferred embodiment of element 1 of thelens shown in FIG. 23.

FIG. 26 shows a detailed side plan half cross sectional view withdimensional attributes of the preferred embodiment of element 2 of thelens shown in FIG. 23.

FIG. 27 shows a detailed side plan half cross sectional view withdimensional attributes of the preferred embodiment of element 3 of thelens shown in FIG. 23.

FIG. 28 shows a detailed side plan half cross sectional view withdimensional attributes of the preferred embodiment of element 4 of thelens shown in FIG. 23.

FIG. 29 shows an electrical schematic diagram of the coaxial illuminatedlaser endoscopic probe and active numerical aperture control apparatus.

FIG. 30 shows a top perspective view in black and white photographicform of a preferred embodiment of the coaxial illuminated laserendoscopic probe and active numerical aperture control apparatus showingillumination and laser light paths without the phototoxicity card, powermeter, and ferrule connectors.

DETAILED DESCRIPTION

Referring now to the drawings, there is shown in the Figures bothpreferred and alternate embodiments of the coaxial illuminated laserendoscopic probe and active numerical aperture control apparatus 10 alsoherein described as an illumination and laser source 10. There isprovided a device 10 for providing non-coherent illumination light 11,62 and coherent laser treatment light 14 through a single optical fiber60 of the size typically used for laser treatment only in a safe,effective, and user friendly manner. The apparatus is especially suitedfor use during ophthalmic surgery.

The present art, in a preferred embodiment, utilizes a 75 watt xenon arclamp 36 for its high luminance illumination (light density), greaterthan 6000° K color temperature, and greater than 95 color renderingindex. A unique and useful feature is the very high luminance and smallsize plasma ball formed on the end of the lamp 36 cathode. If imagedcorrectly the plasma ball is bright enough to provide the requiredillumination input to a small fiber such as that used for lasertreatment. The xenon arc lamp 36 further provides an extremely smallpoint light source which allows for a smaller output illumination beam37 diameter. Unique to the present lamp source is a mount 38 whichallows for replacement of the lamp 36 and yet retains the location ofthe plasma ball of said source 36 precisely at a predetermined locationwithin the optical center 35 of the apparatus.

A classic spherical reflector 40 and two lens 42, 58 light collectionlayout is utilized rather than other lower part count layouts, such asusing an elliptical reflector or a combination of a parabolic reflectorand lens. This technique allows maximum collection efficiency with aminimum of geometric aberration. The lamp 36 is located at thegeometrical center 35 of the reflector 40 and at the focus (focal point)of the first lens 42. Light that is incident on the reflector 40 isreflected back to the lamp 36. This forms an upside down or invertedimage of the source 36 coincidental to the source 36. The first lens 42collimates light from the source 36 and the upside down or invertedimage. The second lens 58 is located coaxial to the first lens 42 andfocuses the light at its focal point. The output optical fiber 60 islocated at the focal point of the second lens 58. The aforesaidreflectors 40 are preferably spherical rather than parabolic in order toreflect illumination light in the same form as sourced from the arc lamp36.

Best form lenses 42, 58 (piano convex aspheric, facing each other) areused in the present art. It was discovered that chromatic aberrations,caused by the lenses, gave the output of the optical fiber 39, 60 eithera yellow or blue cast. This is not a problem with other ophthalmicsources because the source is many times larger than the output opticalfiber. A color corrected “f 1” or possibly 0.5 numerical aperture lensset 42, 58 consisting of four elements was designed to be utilized foreach lens. Each of the elements is coated with a MgF (magnesiumfluoride) anti-reflective coating to minimize light losses, with otheranti-reflective coatings or layers also utilizable. Use of theachromatic lens sets allows a high fidelity image of the illuminationsource 36 to be focused onto the end of the optical fiber 60, 64. Thatis, the multi-element lenses allow for a minimum of chromaticaberration. The aforesaid four element lens set is shown andspecifically described in the Figures.

An additional separate illumination path 62 is possible with the presentart. A 0.5 system numerical aperture or “f 1” lens is the greatestpractical because of limitations to the numerical aperture of availableoptical fibers. This equates to 60 degrees full angle. When thespherical reflector 40 is considered, an additional 60 degrees isprovided from the total of 360 degrees available. Consideration of thevertical rotation around the source 36 is impractical because of shadowscaused by the lamp 36 electrodes. A total of 240 degrees of horizontalrotation around the lamp 36 are left unaccounted for. Allowing foroptics mounts 44 does account for some additional amount. However, atleast half of the illumination output is available. This leaves room fora second light path 62 located orthogonal to the first path 11 alongwith the second fiber output 64. No other conventional illuminationlight source incorporates multiple light paths from a single lamp, thatis two independent collection systems for illumination light. Theindependent nature of the two paths 11, 62 allow different filtering andintensity control settings to the two outputs 39, 41. Output dimming ofthe present art illumination system is accomplished by steering thefirst (collimating) or penultimate lens 42 in a fashion that does notchange the lens 42 numerical aperture or introduce shadow artifacts intothe beam 37. The lens set mount 44 has two halves 46 and a flat spring52. The first part 48 is attached to the optics bench 12, the secondpart 50 holds the lens set 42, and the spring 52 connects the two 48, 50together on one side. Pressure on the lens mount second part 50 causesthe spring 52 to deflect and the lens 42 to move in a directiongenerally perpendicular to the optical axis. This results in motion ormovement of the image across the face of the optical fiber 60, 64whereby the peak illumination of the beam 37 is not centered on theoptical fiber 60, 64 face during dimming. Due to the aforesaid, thereduction of the output light from the fiber 60, 64 without affectingthe color (i.e. color temperature) or aperture of the output isachieved. In a preferred embodiment a shaft mounted cam 54 applies thepressure to the lens mount second part 50 and spring 52. A control knob56 is attached to the other end of the shaft 53 and allows the user toselect the desired illumination level by rotating the knob 56. Thismethod is capable of providing at least 95% reduction in outputillumination intensity. In a preferred embodiment, a shutter 57 ismounted upon the shaft 53 and is rotated across the illumination beam 37in order to fully attenuate the output illumination intensity upon fullrotation of said knob 56. Alternative embodiments may utilize othermethods, including but not limited to electric or electronic drives, torotate said shaft 53 instead of said knob 56.

A dichroic “hot” mirror filter 66 is placed in the collimated space 61between the illumination lenses 42, 58. This provides both UV and IRfiltering of the light. Brackets are attached to the hot mirror 66 mountto provide a means for additional user selectable filters. Positioningof the filters is critical because this is the only area where the light11 is generally normal to the filter surface. Location of the filter 66on the other sides of the lenses would cause the light to have manyundesirable incidence angles (between 0 and 30 degrees). Variation inthe incidence angle causes dichroic reflectors or filters to have ashift in their affect. If absorption filters are used, placement outsidethe collimated space 61 will cause an increase in reflective losses andheating problems.

The output optical fiber connector 98 is uniquely configured to providethe precise positioning required while reducing cost. A preciseconnector or mating end 116 is combined with an integral retentionthread 130 to reduce parts cost and assembly time. An optional groove orrecess 148 is placed on a second version of the connector to provide forsensing the difference between illumination only and laser compatibleoutput fibers. Placement of a smooth diameter connector 74 into theoutput activates a switch 72 which will allow the laser power to bemixed. Either the lack of a connector 98 or the groove or recess 148under the switch 72 will cause the switch 72 to not activate and thelaser power will not be mixed in.

Regarding mixing of laser treatment energy or light 14, laser light 14is delivered to the system via a preferably 50 micron optical fiber 16or equivalent. The connector 18 on the laser end is configured to becompatible with the laser and to provide the necessary interface tosignal to the laser that a fiber is connected. The laser and lightsource 10 end preferably uses an SMA 905 connector or equivalent toallow repeatable connections of the laser delivery fiber 16. Laser light14 exiting the delivery fiber is preferably collimated using a 16 mmfocal length achromatic lens or equivalent 20, i.e. laser collimatinglens, which can also be utilized to focus the collimated laser beam 22.The position of the fiber 16 is adjusted to be at the focal point of thelens 20. The input laser connector 18 and collimating lens 20 arelocated so that the collimated beam 22 is orthogonal to and intersectsthe center of the illumination axis 11 between the illumination lenssets 42, 58 (the collimated area for illumination light). If all safetyrequirements are met (i.e. laser output compatible fiber inserted andselection switch for laser output activated) a steering mirror 24reflects the collimated laser light 22 into the center of theillumination axis 11. The steering mirror 24 is a first surface planothat is positioned at 45 degrees to the laser light 14 and is located inthe center of the illumination axis 11 (when laser mode is active). Aunique aspect of the present invention is that the thickness of themirror 24 is shaped to appear as a circle when viewed along theillumination axis. Due to the 45 degree surface orientation, the shapingcauses the mirror 24 surface to appear elliptical when viewed from anormal angle. The size of the mirror 24 is chosen to be minimally largerthat the collimated laser beam 22. Placement of the steering mirror 24in the center of the illumination axis 11 causes the light rays thatwould normally be there to be blocked and a shadow to appear in thecenter of the output light cone. The second illumination lens 58 focusesthe laser light 14 reflected by the steering mirror 24 onto the end ofthe output fiber 60, 64. Because the length of the output optical fiberstrand is relatively short, the incidence angle of light entering theinput end is very nearly the same angle on the output end. This resultsin the output of the fiber strand having a cone of white light with ashadow in the center nearly filled with the laser aiming beam (treatmentbeam during treatment). That is, the laser provides an aiming beam,typically red, when not fully activated for treatment and a treatmentbeam, typically green, when fully activated. Without the shadow causedby the steering mirror 24 the aiming beam would be entirely washed outor imperceptible except at very low illumination levels.

Alternate embodiments may utilize more than one steering mirror 24 orplace the steering mirror 24 outside of the illumination axis orillumination light path 11 and direct the laser light 14 through anaperture 158 in said spherical reflector 40 and thereafter through thearc lamp 36 plasma ball or through a dichroic reflector 160 or areflector having an aperture 162. All of the aforesaid alternateembodiments place the laser light 14 within the collimated space 61 andutilize the second lens 58 for focus upon the output optical fiber 60.Moreover, all of the aforesaid alternate embodiments provide for asecond light path 62 output as seen in the Figures.

The laser steering mirror 24 is mechanically mounted on a thin post 28that holds it in place while minimizing the loss of illumination light11. The post 28 is mechanically connected to a bracket 30 which isconnected to a solenoid 32. The solenoid 32 causes the bracket 30 andalso the steering mirror 24 to move into one of two positions. Positionone is outside the collimated illumination and laser light. Thisposition is used for no laser delivery and allows the illumination pathto operate unaffected. Position two is with the steering mirror 24located to reflect the laser light into the illumination path 11. Motionof the solenoid 32 and bracket 30 are controlled by a precision ballslide 34. Use of the slide 34 insures repeatable positioning of themirror 24.

As described, unique to the present art is a coaxial laser andillumination path apparatus 10 which heretofore has not be available orutilized. Also unique to the present art is a highly efficientillumination system which utilizes spherical reflectors 40 andassociated lenses 42, 58 to capture a maximum light output and alsoprovide a twin path illumination light output from a single lamp sourcein order to feed fibers of diameter less than 500 microns. Furtherunique to the present art is a laser or steering mirror 24 having asolenoid 32 selectability which provides an aiming hole within theillumination path 11 for laser placement. Still further unique to thepresent art is an illumination arc lamp 36 system having an extremelysmall point light source 36 which allows for an extremely smallillumination focus size or numerical aperture output. Also unique to thepresent art is an arc lamp 36 mount 38 which precisely andinterchangeably places the plasma ball of the arc lamp 36 at the focusor optical center 35 of the optics system. Also unique to the presentart is a unique dimming mechanism which moves the focal point of anoutput dimming or first lens 42 in order to provide dimming withoutintroducing artifacts, chromatic aberrations, or change of colortemperature. Also unique to the present art is a capability ofconnection with existing conventional laser light sources whereby lasertreatment and illumination are both provided at an output of the presentart apparatus 10. The optical system of the present apparatus 10 isuniquely capable of accepting the input cone angles of the illumination33 and laser light 15 placed at the output optical fiber 60 andsubstantially reproducing said cone angles at the output of the opticalfiber, typically where the endoscopic probe is located, with anyaberrations caused by the optical fiber itself.

Further alternate embodiments of the present art apparatus 10 mayutilize parabolic reflectors instead of spherical reflectors in order tocollimate the illumination source 36. This technique would eliminate theneed for the first collimating lens 42 and allow transmission of thelaser beam 22 through an aperture within the parabolic reflector or viaa steering mirror 24 within the collimated space 61. Still furtheralternate embodiments may utilize an elliptical reflector having twofocal points whereby the illumination source 36 is placed at the firstfocal point and the output fiber 60 is placed at the second focal pointwith the laser beam 22 introduced through an aperture within theelliptical reflector or via a steering mirror 24 between theillumination source 36 and the output fiber 60. This latter alternateembodiment requires focusing the laser beam 22 onto the output fiber 60via a lens placed within the laser beam path 22 prior to the outputfiber 60 yet allows elimination of both the first collimating lens 42and the second focusing lens 58.

Some of the variables which determine the phototoxicity risk levelduring vitreoretinal surgery include the spectral and powercharacteristics of the light source used, the type and size of theendoilluminator probe, the length or duration of the surgical procedure,and the area (size) of the illuminated tissues. In each case the surgeonmust make a risk-benefit judgement about the intensity of light to beused. Use of insufficient intensity may result in inadequatevisualization and adverse effects more serious than a retinal photicinjury. Currently, the calculation of the exposure time required toreach a point of injury is a tedious chore involving the numericalintegration of the spectral power density function of the light source36 with a hazard function (see ISO 15752), and specific knowledge of thesurgical illumination area and endoilluminator characteristics. Thepresent art invention further represents a novel apparatus and methodfor providing the ophthalmic surgeon with graphical photoxicity riskinformation in a clear and easy to understand manner. In a preferredembodiment, an inexpensive photoxicity risk card 76 is removablyattached to the control panel of the surgical illumination and laserlight source 10. Preferably, the present art card 76 is attached inclose proximity to the light intensity control knob 56 in order to showthe relationship between the output intensity of the light source andthe likelihood of photic injury. The card 76 is preferably included witheach endoilluminator instrument, i.e. optical fiber, that is calibratedto represent the phototoxic performance of that instrument type whenused with a particular type of light source. The graphicalrepresentation 78 on the card 76 acts as a guide for adjustment of theoutput intensity of the source 10 in relationship to an acceptedstandard, that is such as the “Millennium” from Bausch and Lomb®. Inthis way the spectral and power characteristics of the various elementsinvolved in delivering light to the eye are integrated into a single andeasily manageable variable. This greatly reduces the complexity ofjudging the best intensity to use in a given situation. Alternativeembodiment graphical representations 78 could present other informationregarding the light output such as lumen output (a unit that is weightedby the photopic response of the eye). Other representations couldpresent threshold information when used with special dyes or coloredlight filters.

A preferred embodiment of the invention comprises a card 76 that isdie-cut from white chipboard stock that is approximately the weight of abusiness card. The shape of the card 76 is generally square with a slot90 removed from one side to enable the card 76 to be placed behind theintensity control knob 56 of the illumination and laser source 10 whileproviding clearance for the control shaft 53 which is turned by saidknob 56. In a preferred embodiment, four location pins 92 are attachedto the front panel of the illumination and laser source 10 enclosure.The pins 92 provide boundaries for card 76 location and tend to inhibitrotation of the card 76 with the control knob.

In a preferred embodiment, onto the face of the card is printed acircular shaped scale 84 that has different color bands 86 representingthe phototoxicity risk at a given intensity level, for example green,yellow, and red. The control knob 56 has an indication line that pointsto the current output intensity level and concurrent phototoxicity riskassociated with the probe being used. Unique to the present art is theability of the card 76 to indicate output intensity at the optical fiberoutput. The card 76 is meant to be disposed of after a single use andreplaced with a new one provided with each optical fiber instrument. Inthis manner the output of the light source 10 is recalibrated each timeit is used. The calibrated unit type may vary with different instrumentstyles to provide the surgeon with the most pertinent informationpossible.

As aforesaid the card 76 provides a known point of reference relative tothe prior art illumination devices. For example, if the surgeonmaintains the knob 56 indicator line within the green color band, he orshe will understand that the light intensity output is within the safeintensity of the prior art illuminators such as the “Millennium” fromBausch and Lomb®. This control phenomena is especially useful whenutilizing more powerful illumination sources 10 such as describedherein. That is, the surgeon must have a prior art point of referencewhen utilizing more powerful and modern illumination systems such as thepresent art. The art of the present invention may further provideseveral bands which do not provide a reference to the prior art butinstead indicate phototoxicity levels or light intensity levels directlyto the surgeon.

Unique to the present art is the ability of the manufacturer of theoptical fiber to provide a phototoxicity risk card 76 which accounts forattenuation and spectral absorption within the optical fiber providedwith said card 76. Thus for example, if an optical fiber is highlyattenuating, the card may indicate that the surgeon must turn theintensity control knob 56 to a higher level in order to obtain anequivalency to one or more of the aforesaid prior art illuminators or toachieve a desired photo-illumination output.

The art of the present invention also comprises a ferrule or connector98 having an internal bore 102, preferably stepped 104, which issubstantially parallel with the lengthwise axis 100 of the ferrule body98. The aforesaid bore 102 allows for placement and bonding or pottingof an optical fiber within and through said ferrule body 98. Externally,said ferrule body 98 is also stepped 112, 148 in a unique form in orderto optimally function as described herein.

In a preferred embodiment, the ferrule body 98 has an external end 114and a mating end 116 and externally comprises a substantiallycylindrical head 118 of a first diameter 120 having a first end 122 anda second end 123, said first end 122 co-located with said external end114. Said ferrule body 98 further externally comprises a lip 124 ofgreater diameter than said head 118 and having a first side 126 and asecond side 128 with said first side 126 mounted with said second end123 of said head 118. A threaded portion 130 of preferably smallerdiameter than said head 118 is attached with and extends from said lip124 second side 128. In a preferred embodiment, said threaded portion130 first comprises an 8-32 UNC thread with a first end 132 and secondend 134, said first end 132 connected with said second side 128 of saidlip 124. Also in a preferred embodiment, said threaded portion 130 has agroove 136 of approximately 0.030 inch at said first end 132 withapproximately 0.090 inch of said thread 130 thereafter following andanother approximately 0.030 inch groove 136 following said thread 130 atsaid second end 134. Externally the ferrule body 98 also has analignment barrel 138 having a first 140 and second 142 end followingsaid threaded portion 130, said first end 140 attached with saidthreaded portion 130. The second end 142 of said alignment barrel 138 isco-located with said mating end 116 of said ferrule body 98. Also, saidsecond end 142 of said alignment barrel 138 contains an orifice 144 ofsubstantially equivalent or slightly greater diameter as the opticalfiber mounted within said stepped bore 102. Said orifice 144 isinterconnected with said internal stepped bore 102. In an embodiment ofthe present art, said orifice is approximately 0.011 inch in diameterand 0.025 inch in length. Also in a preferred embodiment, said alignmentbarrel 138 has a chamfer 146 at the circumference of said second end142. Preferably said chamfer 146 is of approximately 45 degree angle and0.015 inch in length. Alternative embodiments may utilize chamfers ofdifferent angles or shapes or forego use of a chamfer altogether.

The alignment barrel 138 of the present art is uniquely shaped withinthe embodiments to indicate whether laser light or illumination lightshould be applied to the optical fiber. In a preferred embodiment of thelaser ferrule, the alignment barrel is of uniform diameter,approximately 0.118 diameter, which indicates to the source 36 thatlaser light or energy is desired. In a first alternative embodiment orillumination ferrule, the alignment barrel contains a recess 148 locatedapproximately 0.075 inch from said barrel 138 second end 142 andextending approximately 0.268 inch from said second end 142. Whenutilized, the illumination and laser source 10 detects this recess anddetermines that illumination light and not laser light is desired.Further alternative embodiments may utilize the aforesaid recess 148embodiment for laser light and the uniform barrel diameter forillumination light.

Internally said stepped bore 102 first comprises a first larger boresubstantially within said head portion which is of approximately 0.098inch diameter and extends substantially the length of said head. Asecond intermediate bore of approximately 0.063 inch diameter extendsfrom said first larger bore to said orifice 144 within said threadedportion 130 and said alignment barrel 138. Also in a preferredembodiment, the orifice 144 length is approximately 0.025 inch.Alternative embodiments may utilize first and second bores and orificeshaving a plurality of diameter and length sizes provided that thediameter portions are smaller than the ferrule external portions withinwhich each is located.

When assembled with an optical fiber, the optical fiber extends throughsaid bore 102 and orifice 144 and terminates substantially flush withsaid ferrule body 98 mating end 116 or second end 142 of said alignmentbarrel 138. Preferably said optical fiber is held within said bore 102via potting or adhesive compounds surrounding said fiber and attachingwith said bore 102 of the ferrule 98.

In a preferred embodiment, the external head 118 diameter isapproximately 0.234 inch with a length of approximately 0.375 inch. Thelip 124 external diameter is approximately 0.312 inch with a thicknessof approximately 0.025 inch. Also, said alignment barrel 138 isapproximately 0.118 inch in diameter and 0.380 inch in length.

Where provided, dimensions, geometrical attributes, and thread sizes arefor preferred embodiment informational and enablement purposes.Alternative embodiments may utilize a plurality of variations of theaforesaid without departing from the scope and spirit of the presentinvention. This is especially true as relating to said head 118, lip124, and threaded portion 130. Said lip 124 may be integrated as part ofthe head 118 or removed completely. Also, the position, location, andtype of threaded portion 130 may vary. Said threaded portion 130 may notutilize said grooves 136, utilize grooves of a shorter or longer length,or have said head 118 and lip 124 diameters sized substantially the sameas or smaller than the outside diameter of said threads 130. The art ofthe present invention may be manufactured from a plurality of materials,including but not limited to metals, plastics, ceramics, or composites.

Unique to the present invention is the integral inclusion of a laserpower meter 150 having a sensor 152, a power display 154, and associatedcontrol circuitry 156. The power meter 150 allows a surgeon to place theendoscopic fiber optic probe onto said sensor 152, energize the laserthrough the illumination and laser source 10 and measure the laser poweroutput as seen on said display 154. Inclusion of the aforesaid isespecially useful due to variations in optical fibers or to account forattenuation through the illumination and laser source 10. By utilizingthe power meter 150, the surgeon has complete knowledge of the laserpower transmitted to the surgical site. Alternative embodiments mayutilize said power meter 150 for measurement of the output illumination37 intensity as well as the laser light 14 power.

In operation, the surgeon connects a laser light source via opticalfiber to the input laser connector 18 on the apparatus 10. The surgeonthereafter connects a ferrule connector 98 with an integral opticalfiber connected with an endoscopic probe at the first output 39 or forillumination only at said second output 64. If said ferrule connector 98at said first output 39 does not have the aforedescribed recess 148, theapparatus 10 will allow the steering mirror 24 to position within theillumination light path 11 and further allow transmission of laserlight. If the surgeon desires to measure laser power output, he or sheplaces the output end of the endoscopic probe onto said sensor 152 andupon full laser activation, reads the laser power output on the display154. If the apparatus 10 is powered, the surgeon proceeds to illuminatethe tissues of concern with a cone of white illumination light having ashadow where the laser beam will be placed and a typically red laseraiming beam within said shadow. Upon full activation of laser power, atypically green treatment laser beam replaces said typically red aimingbeam to treat the tissues of concern. All of the aforesaid illuminationand treatment may be achieved with a single incision and through asingle optical fiber of smaller diameter than prior art sources.

Those skilled in the art will appreciate that a coaxial illuminatedlaser endoscopic probe and active numerical aperture control apparatus10 (illumination and laser source) and method of use such has been shownand described. The apparatus and method of use allows for simultaneoustransmission of illumination and laser treatment light through a singleoptical fiber of a size which is typically utilized for laser treatmentlight only. The apparatus and method further provides control of theangular light output from the endoscopic probe attached with saidoptical fiber. The apparatus also provides for distinct and separateillumination without utilization of the treatment laser while providingcomplete intensity control of said illumination. Those skilled in theart will appreciate that a medical light intensity phototoxicity controlor risk card 76 has also been shown and described for use with thepresent art. Said phototoxicity risk card 76 is especially useful forquick and easy determination of illumination intensity output from aspecific type of optical fiber or higher power source such as thepresent art. Those skilled in the art will appreciate that a photonillumination and laser ferrule connector 98 has also been shown anddescribed. Said ferrule 98 is especially useful for quick and positiveconnection of an optical fiber to a laser or illumination source 10 asherein described and further allows said source 10 to distinguish theoptical fiber type or use, that is for illumination or medical laserapplication. The present art device is useful during surgery andespecially ophthalmic surgery. Also, those skilled in the art willappreciate the integral inclusion of a laser optical fiber output powermeter.

Having described the invention in detail, those skilled in the art willappreciate that modifications may be made of the invention withoutdeparting from its spirit. Therefore, it is not intended that the scopeof the invention be limited to the specific embodiments illustrated anddescribed. Rather it is intended that the scope of this invention bedetermined by the appended claims and their equivalents.

1. A ferrule connector for use with an illumination or laser sourcecomprising: a ferrule body having an internal bore having an opticalfiber; and a head; and a threaded portion attached with and followingsaid head; and an alignment barrel attached with and following saidthreaded portion; and a mating end opposite said threaded portion; andan orifice in said mating end of substantially equivalent or greaterdiameter than said optical fiber.
 2. The ferrule connector for use withan illumination or laser source as set forth in claim 1 furthercomprising: a recess within said alignment barrel whereby said opticalfiber may be distinguished for use with a laser light source, anillumination light source, or both.
 3. The ferrule connector for usewith an illumination or laser source as set forth in claim 1 whereby:said threaded portion is an 8-32 UNC thread.
 4. The ferrule connectorfor use with an illumination or laser source as set forth in claim 2whereby: said threaded portion is an 8-32 UNC thread.
 5. A ferruleconnector for use with an illumination or laser source comprising: aconnector body having an external end, a mating end, an internal borewhich is substantially parallel with a lengthwise axis of the connectorbody, and an externally stepped form; and an optical fiber mountedwithin said bore; and a head of a first diameter having a first end anda second end, said first end co-located with said external end; and athreaded portion of a smaller diameter than said head attached with saidhead; and an alignment barrel having a circumference, a first end, and asecond end, said first end of said alignment barrel attached with saidthreaded portion and said second end of said alignment barrelsubstantially co-located with said mating end of said body; and saidsecond end of said alignment barrel having an orifice of substantiallyequivalent or slightly greater diameter as said optical fiber mountedwithin said bore and interconnected with said bore and said opticalfiber terminated substantially flush with said second end of saidalignment barrel; and said connector body with said alignment barrelcapable of providing a quick and positive connection of said opticalfiber to a laser source or an illumination source.
 6. The ferruleconnector for use with an illumination or laser source as set forth inclaim 5 further comprising: a lip on said body of a greater diameterthan said head and having a first side and a second side with at least aportion of said first side substantially mounted with said second end ofsaid head and said threaded portion substantially attached with andextending from at least a portion of said lip second side.
 7. Theferrule connector for use with an illumination or laser source as setforth in claim 5 further comprising: a recess within said circumferenceof said alignment barrel; and said recess indicating to said sourcewhether said optical fiber is designed, best suited, or desired for anillumination light or a laser transmission light.
 8. The ferruleconnector for use with an illumination or laser source as set forth inclaim further comprising: a recess within said circumference of saidalignment barrel; and said recess indicating to said source whether saidoptical fiber is designed, best suited, or desired for an illuminationlight or a laser transmission light.
 9. The ferrule connector for usewith an illumination or laser source as set forth in claim whereby: saidalignment barrel has one or more steps within said circumference; andone or more of said steps indicating to said source whether said opticalfiber is designed, best suited, or desired for an illumination light ora laser transmission light.
 10. The ferrule connector for use with anillumination or laser source as set forth in claim 6 whereby: saidalignment barrel has one or more steps within said circumference; andone or more of said steps indicating to said source whether said opticalfiber is designed, best suited, or desired for an illumination light ora laser transmission light.
 11. The ferrule connector for use with anillumination or laser source as set forth in claim 5 whereby: saidthreaded portion is an 8-32 UNC thread.
 12. The ferrule connector foruse with an illumination or laser source as set forth in claim 6whereby: said threaded portion is an 8-32 UNC thread.
 13. The ferruleconnector for use with an illumination or laser source as set forth inclaim 7 whereby: said threaded portion is an 8-32 UNC thread.
 14. Theferrule connector for use with an illumination or laser source as setforth in claim 8 whereby: said threaded portion is an 8-32 UNC thread.15. The ferrule connector for use with an illumination or laser sourceas set forth in claim 9 whereby: said threaded portion is an 8-32 UNCthread.
 16. The ferrule connector for use with an illumination or lasersource as set forth in claim 10 whereby: said threaded portion is an8-32 UNC thread.
 17. The ferrule connector for use with an illuminationor laser source as set forth in claim 5 whereby: said internal borecomprises one or more bores of a larger diameter than said orifice; anda potting or an adhesive compound within one or more of said bores oflarger diameter whereby said optical fiber is attached with saidinternal bore.
 18. The ferrule connector for use with an illumination orlaser source as set forth in claim 7 whereby: said internal borecomprises one or more bores of a larger diameter than said orifice; anda potting or an adhesive compound within one or more of said bores oflarger diameter whereby said optical fiber is attached with saidinternal bore.
 19. The ferrule connector for use with an illumination orlaser source as set forth in claim 9 whereby: said internal borecomprises one or more bores of a larger diameter than said orifice; anda potting or an adhesive compound within one or more of said bores oflarger diameter whereby said optical fiber is attached with saidinternal bore.
 20. The ferrule connector for use with an illumination orlaser source as set forth in claim 11 whereby: said internal borecomprises one or more bores of a larger diameter than said orifice; anda potting or an adhesive compound within one or more of said bores oflarger diameter whereby said optical fiber is attached with saidinternal bore.